Senior cancer nurse leadership posts will be recruited in London to develop specialist nursing

Five innovative new senior nursing leadership posts are being recruited to support the development of cancer clinical nurse specialists (CNSs) in London. A project to pilot Macmillan CNS Development Leads (CDLs), led by the North Central London Cancer Alliance and funded by Macmillan Cancer Support and NHS England, aims to address the shrinking pool of experienced CNSs and falling number of nurses opting to move into this specialist role. The pilot will implement the ACCEND (Aspirant Cancer Career and Education Development) programme, developed NHS England Workforce, Education and Training for cancer nursing.

Cancer clinical nurse specialists play a pivotal role in patient care, offering clinical expertise, knowledge, and compassionate support in a holistic manner through personalised cancer care. They also help patients to navigate the complexities of the healthcare system. In recent years, however, fewer registered nurses are attracted to the role and there has been a lower retention rate of CNSs. This pilot for the cancer nursing fits into the overall NHS Workforce plan.

The key issues currently impacting the CNS workforce are:

• Loss of workforce due to retirement
• Misunderstanding of the cancer CNS role
• Limited exposure to cancer nursing in the undergraduate curricula
• Difficulty in navigating career progression routes
• Impact of the COVID-19 pandemic on work-related fatigue

Introducing the Macmillan Cancer CNS Development Leads (CDL) is a step towards addressing the challenges of recruiting and retaining qualified professionals in the cancer nursing workforce.

The postholders will provide structured professional support to new CNSs by offering mentoring, coaching, and education based on the ACCEND capability framework. By using this framework, the Macmillan CDLs will support nurses in developing a solid foundation of knowledge and skills necessary to excel in their roles. CDLs will help a cancer CNS to be able, independently, to undertake proactive case management and use clinical judgement to reduce the risk to patients from disease or treatments. This will strengthen and improve delivery of personalised cancer care by supporting cancer clinical nurse specialists and nurse-led innovation.​ 

There will be one Macmillan CDL in each of the five Integrated Care Systems in London. Each will be responsible for supporting 10 to 18 CNSs across the participating hospital trusts in each area. They will use the ACCEND capabilities framework to assess the progress of each cancer CNS.

Ali Malik, Managing Director, North Central London Cancer Alliance, said: “Maintaining and developing a cancer CNS workforce is vital for development of high-quality cancer services. We are delighted to be leading this project and collaborating with our colleagues across the capital to improve and champion the role of the cancer CNS.

“Each healthcare area will have a CNS Development Lead, but we all recognise the need to have that bespoke support from an experienced senior nurse who will help CNSs to fully grow into their roles. At a time of increasing demand for cancer services, this will help build greater workforce resilience and long-term sustainability in London.”

Gabriella Massa, Workforce Transformation Manager, NHS England, said: “Creating a strategy to recruit and retain cancer CNS is crucial to support the workforce and for maintaining a high level of patient safety. We are very pleased to have co-funded this project and look forward to seeing how it will impact the future workforce and what lessons learnt can be shared and applied in other sectors of healthcare.”

Yvonne Beadle, Strategic Partnership Manager at Macmillan Cancer Support, said: “We’re proud to be working with the London Cancer Alliances, NHS England, and other key London stakeholders to fund these five new leadership roles which will help strengthen the cancer workforce in London.

“By providing expert mentorship, the nurses in these senior roles will be able to pass on their experience to new CNS post-holders, giving them the time and opportunity to develop. This will help to retain and support high levels of care within our cancer nursing services and develop the cancer nursing leadership of the future.

“Cancer Clinical Nurse Specialists are at the heart of good cancer care; patients often tell us how much they value their CNS and support they provide. This investment will ultimately make a huge difference to people living with cancer in London at a distressing time in their lives.”

The two-year pilot will be independently evaluated to understand what needs to be improved, to assess the effectiveness and value for money of the CDL role and support the sustainability of these posts.